‘No’ to Medicare voucher system

As an active, healthy senior and a government retiree, I’ve sometimes taken my personal Medicare benefits for granted. Medicare takes care of my annual wellness visits, pays for the periodic treatments that keep skin cancer at bay, and helps me stay mobile with physical therapy for sciatica — a recent reminder that I’m getting older.

But proposals to turn Medicare into a voucher system have me concerned for the 218,974 other Hawaii residents on Medicare and the additional 268,118 people in our state (including my sons and daughters) who will enter the program in the next 15 years.

Under a voucher system, the basic premise of guaranteed coverage would be tossed aside. Instead, consumers would get a fixed dollar amount to help pay for care in the private marketplace. If that amount is insufficient, tough luck!

Nationally, 1 in 4 Medicare beneficiaries has an income below $14,350, and 1 in 2 has an income below $24,150. Hawaii’s numbers are similar and our cost of living is considerably higher. Raising their health care costs could be disastrous, forcing many to choose between doctor visits and other necessities such as food and rent.

Hawaii residents in poor health would quickly feel the pain of a voucher system. They include the 33 percent who have two or three chronic health conditions and rely on care they can afford. Many with limited resources could end up in health plans that restrict their choice of doctors and demand high out-of-pocket spending for needed care.

Vouchers may mean increased costs for over 43,000 state and county retirees who get their insurance from the Employer Union Health Benefits Trust Fund. If vouchers don’t keep up with the rising costs of health care, retirees, current workers paying into the system, and taxpayers could end up paying the difference.

The problem is health care costs — especially prescription drug costs — that are outpacing people’s incomes. For example, the average cost for a year’s supply of a prescription drug more than doubled between 2006 and 2013. At over $11,000 today, that’s about three-fourths of the average Social Security retirement benefit, or almost half the median income of people on Medicare.

Risks connected to vouchers are widely recognized. Studies by the Congressional Budget Office and Medicare Payment Advisory Commission suggest that moving to vouchers could hit most Medicare beneficiaries in the pocketbook.

Yes, Medicare needs to be strengthened. But shifting costs to seniors and workers who’ve paid into the system their entire working lives is the wrong approach. We can put Medicare on stable ground with common-sense solutions, such as clamping down on drug companies’ high prices, improving coordination of care, and getting rid of over-testing, waste and fraud.

Finally, the voucher proposal contradicts President Donald Trump’s commitment to protecting Medicare. During the campaign, Trump told voters: “I am going to protect and save your Social Security and your Medicare. You made a deal a long time ago.”

Congress needs to follow the president’s lead.

Older voters helped decide the election and they’re counting on Congress to abandon this proposal. AARP is committed to working with elected officials of both parties to ensure that Medicare remains financially stable. But solutions must be responsible. On behalf of our nearly 150,000 members in Hawaii and 38 million throughout the nation, AARP will continue to champion a Medicare system that delivers on the deal that Americans have counted on and deserve.

If you share our opposition to a Medicare voucher system, contact your congressional members to make sure your voice is heard.

Gerry Silva is the volunteer state president of AARP Hawaii.